American Academy of Emergency Medicine

Emergency Nurse-to-Patient ED Staffing Ratios

Whereas the volume of ED visits continues to rise and now exceeds 100 million in the United States annually; and

Whereas the scope of Emergency Medicine requires a high intensity of service for many conditions, especially during the first hour of treatment; and

Whereas emergency nursing involves patient evaluation, interval assessments, medication administration, procedure assistance, point-of-care testing, chart documentation, and aftercare education; and

Whereas emergency patient work-ups are getting more involved due to admission prevention strategies of managed care organizations; and

Whereas emergency nurses provide a vital role in medical error reduction in one of the highest risk areas (according to the Institute of Medicine); and

Whereas a reduced regular staffing pool results in the use of inexperienced nurses during crisis periods (e.g., influenza season);

Therefore be it resolved that AAEM asserts that, as a guideline for comprehensive, moderate acuity emergency departments, the minimum emergency nurse-to-patient staffing ratio should be 1:3 or based on the rate of patient influx such that the rate of 1.25 patients per nurse per hour is not exceeded. In addition, dedicated triage and charge nurses are necessary in higher volume departments.